National Health Fund – A Decade of Advancing Health Care

The National Health Fund (NHF) has, for a decade, provided Jamaicans with improved health benefits, spending $17.6 billion up to the end of January 2014, on medication subsidy, and $9.72 billion to improve facilities.

Another $1 billion has been spent on the prevention of a number of illnesses.

Primarily, the agency was tasked to manage non-communicable diseases (NCDs), by providing a subsidy for prescription medication, and support for public and private sector entities involved in primary health care.

The NHF is also involved in health promotion and illnesses prevention. Due to the success of the NHF model, other countries in the region have sought to establish similar entities as part of their universal health care plan.

The Fund has also received praise from the World Bank. “The NHF has been a successful health financing instrument, generating a steady income for health services. The NHF not only subsidises prescription drugs for NCD patients, but also provides funding for health infrastructure improvement and public health activities, such as health promotion,” the World Bank stated in a 2011 report on health care financing in the Region.

The report said this was the major difference between the NHF and other systems in the Caribbean region, such as the Barbados Drug Scheme, and Trinidad and Tobago’s Chronic Disease Assistance Plan.

The NHF increased access to treatment and care for the secondary prevention of NCDs, implemented measures to help slow the progression of these diseases, by making the treatment of major NCDs more affordable, and removing financial barriers to treatment.

Minister of Health, Hon. Dr. Fenton Ferguson, says the NHF is one of the most “far reaching health policies, not only in Jamaica, but in the Caribbean. It has significantly transformed the health landscape; it has done such a tremendous job over these 10 years, worthy of international recognition”. He was speaking at the recent 10^th anniversary banquet held at the Jamaica Pegasus Hotel, New Kingston, where a number of NHF staff, beneficiaries, and other persons were recognized.

Persons suffering from 15 illnesses can register for a health card and use it to obtain reduced payment for drugs. These conditions include: breast cancer, prostate cancer, hypertension, ischaemic heart disease, rheumatic fever, high cholesterol, vascular disease, diabetes, epilepsy, major depression, glaucoma, psychosis, asthma, arthritis, and benign prostatic hyperplasia.

Patrick Henderson, an early beneficiary, who was recognised by the agency recently, said over the years the NHF card has helped him to make significant savings on medication. “It is the best thing that has happened to the health system, because, this card is really helpful; I don’t know what I would do without the card,” Mr. Henderson says.

Another beneficiary, Alphea Clarke, who was also awarded at the banquet, said the card has proven to be of great help, as she only works two weeks per month, and she requires medication on a regular basis.

Part of the NHF’s health promotion element includes the “Work It Out” Challenge, a weight loss team competition, that encourages individuals to change their lifestyles to achieve a healthier mind and body. There is also a School Wellness Programme, which encourages students to be physically active, and to eat healthy.

The agency also runs the High School Screening Programme for students from Grades 7 to13. Screening is done by the Heart Foundation of Jamaica, and children are elected based on their medical and family histories. Once an abnormality is detected, the school nurse is consulted and a medical follow up is encouraged, as well as lifestyle changes.

To achieve its goal of managing and reducing chronic illnesses, the NHF partners with other health groups to reach targeted areas, and also organises health fairs and community health days across the island. “When we go out, we usually get overwhelming responses especially from the elderly. It is a great pleasure to assist them,” explains NHF Administrative Assistant, Nicole Crump.

Health Promotion Coordinator, Rosemarie Stewart, one of the officers responsible for the many outreach events, said it is a joy for her when “someone who has a chronic disease and they would not normally be able to afford their medication, and now they can because they have a card to help them to pay for it; and can now lead a normal and healthy life,” Mr. Stewart said.

Chief Executive Officer, Everton Anderson informs that the number of medications covered by the NHF card has been increased to 1,500. The Fund’s information technology capacity has also been upgraded to enhance efficiency.

“The NHF seeks to encourage the awareness of and need for individual responsibility with the theme ‘Taking responsibility for your health.’ We also educate the public on healthy living and illness management in health promotion, by providing free screening tests in schools and communities,” he says.

Former Health Minister, John Junor, under whose tenure the NHF was established, said the disease burden in the country at the time had shifted from infectious to NCDs, where over 60 per cent of the health care expenditure was going towards treating preventable illness. He said it became necessary to take action to subsidise medication for these major NCDs.

“The number of people who I meet daily, who speak highly of the programme and the effect it has had on their own lives, it is for me sufficient justification that we went along the right path. Apart from the subsidies and the health promotion components, it has established for the first time, a reliable database of your chronic non communicable sufferers,” he said, noting that with the health card, health professionals at the primary system can now keep track on how persons are taking care of themselves,” he said.

Established in April, 2003, the NHF has some 284,880 beneficiaries, with satellite offices in Montego Bay, Ocho Rios, and Mandeville. Persons can register for the health card at hospitals, health centres, and at pharmacies. The agency is funded through a special tax on cigarettes, and a percentage of National Insurance scheme (NIS) contributions.